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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

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Articles 1,063 Documents

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Positive nikolsky sign and â€œpinpoint lake of pusâ€ in acute generalized exanthematous pustulosis: a case report Ketut Alit Pinidha Savitri; Ketut Suteja Wibawa; Komang Harry Supradnyan
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Introduction: Acute generalized exanthematous pustulosis (AGEP) is a severe, usually drug-related reaction, characterized by an acute onset of mainly small non-follicular pustules on an erythematous base and spontaneous resolution usually within two weeks. Current report aims to present management of AGEP in our center at Singaraja Regional Hospital, Bali-Indonesia.Case: A 78 years old woman with a history of acute coronary syndrome, was reported to have a severe allergic drug reaction. Patients reported taking cefixime medication for the past 2 days because of acute bronchitis. The patient was hospitalized because of the complaint, and diffuse miliary pustules were found above the base of erythematous skin. On examination of lesions, the Nikolsky sign was positive on lesions in the back and abdomen without any tenderness. Histopathological examination was suitable for the diagnosis of acute generalized exanthema pustulosis (AGEP). Systemic intravenous corticosteroid with oral antihistamines was choosen as a primary treatment for this patient.Conclusion: Treatment is based on the removal of the causative drug, supportive care, infection prevention and use of potent topical or systemic steroids

Annular pancreas in two cases after diamond-shaped anastomosis duodenoduodenostomy: case reports Ni Luh Gede Wahyuni Suismaya; I Made Kardana; Kadek Deddy Ariyanta
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Annular pancreas is an infrequent congenital disorder characterized as a partial or complete pancreatic tissue around the descending part of the duodenum. Prenatal control is essential in the early detection of the annular pancreas. Initial management might increase better prognosis. We report two cases of the annular pancreas in Sanglah General Hospital, Denpasar, Bali in 2016-2019 to describe the clinical characteristics and outcome of different ages in annular pancreas managed by diamond-shaped duodenoduodenostomy.Case Description: The first case was a six days old baby boy with bile stained vomiting every time he breastfed when she was three days old and got worsen. USG fetal showed polyhydramnios with duodenal or jejunal stenosis. Besides, the abdominal X-ray showed double bubble sign and the laboratory findings were in a standard limit. The second case was a nine months old girl with bile-stained vomiting when she was eight months old and got worsen along with the time. She found with severe malnutrition and mild-moderate dehydration. The laboratory examination revealed electrolyte imbalanced, and abdominal X-ray showed double bubble sign. Postoperative to first feed was 1 day in both cases and full feed duration was 5 and 10 days. Length of stay was 16 and 25 days—both of the cases without complication after surgery.Conclusion: Annular pancreas is a rare congenital malformation that manifests primarily by signs related to duodenal obstruction. Earlier identifications will help to ensure that appropriate treatment can be instigated as soon as possible. Treatment by surgical with duodenoduodenostomy procedure is a surgical technique in the treatment of annular pancreas, with the advances in neonatal intensive care, may reduce the postoperative complications and will make a better outcome.

Karakteristik pasien batu ginjal dengan tatalaksana retrograde intra-renal surgery di Rumah Sakit Umum Pusat Sanglah dan Rumah Sakit Surya Husada: initial report tahun 2017-2019 I Made Nugraha Gunamanta Sabudi; Gede Wirya Kusuma Duarsa; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa; Ida Bagus Putra Pramana; Anak Agung Gde Oka
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Renal stone is frequent cases that happened in the community. There are a lot of options to treat renal stone; one of them is RIRS. RIRS is an alternative procedure after ESWL and PNL for renal stone.Method: Twenty-seven samples as total sampling of all patients that were done with RIRS in Sanglah Hospital and Surya Husada Hospital from January 2017 until June 2019 retrospectively. Data were collected secondary from Medical Reports of the patients and showed a descriptive study depict how the RIRS patient characteristic in Sanglah Hospital and Surya Husada Hospital. All RIRS patients showed that the RIRS procedure is secondary due to history of ESWL, PNL, URS with insertion of DJ Stent, and or Nephrolithotomy.Results and Conclusion:Characteristic of age in this study was 52,41 years old in mean value, with male and female per cent, respectively 62,96% and 37,04%. Stone size of the study was classified to 4 cluster which are: (1) 37,04% cluster with stone size <1 cm, (2) 33,33% cluster with stone size â‰¥1cm to <2cm, (3) 3,70% cluster with stone size â‰¥2 cm, and (4) 25,93% cluster that with stone size unknown. This study also showed some similarity with two other studies about patient characteristic of RIRS treatment.Â Latar Belakang: Batu ginjal adalah kasus yang sering terjadi di masyarakat. Terdapat banyak pilihan tindakan untuk mengambil batu ginjal salah satunya adalah dengan tindakan RIRS. Tindakan RIRS masih menjadi alternatif tindakan setelah pilihan pertama PNL dan ESWL untuk batu ginjal.Metode: Penelitian ini mengambil 27 sampel pasien dari total sampling seluruh pasien yang dilakukan RIRS di Rumah Sakit Umum Pusat (RSUP) Sanglah dan Rumah Sakit (RS) Surya Husada selama Januari 2017 hingga Juni 2019 secara retrospektif. Data didapatkan dari data sekunder rekam medis pasien. Penelitian disajikan secara deskriptif memberikan gambaran karakteristik pasien yang mendapatkan tindakan RIRS. Seluruh pasien yang dilakukan RIRS di RSUP Sanglah dan RS Surya Husada merupakan pasien dengan mendapat RIRS Sekunder setelah sebelumnya memiliki riwayat pernah ESWL, PNL, URS dengan pemasangan DJ-stent, dan atau nefrolitotomi.Hasil dan Simpulan: Karakteristik usia rata-rata pada penelitian ini adalah 52,41 tahun dengan perbandingan persentase laki-laki perempuan berturut-turut 62,96% dan 37,04%. Ukuran batu pada penelitian dikelompokkan menjadi 4 kelompok dengan masing-masing kelompok: (1) 37,04% kelompok dengan ukuran batu <1 cm, (2) 33,33% kelompok dengan ukuran batu â‰¥1cm s/d <2cm, (3) 3,70% kelompok dengan ukuran batu â‰¥2 cm, (4) 25,93% kelompok yang ukuran batunya tidak tercantum.

Uji efektivitas ekstrak air daun ubi jalar ungu (Ipomoea batatas) terhadap profil lipid tikus putih jantan galur wistar yang diinduksi pakan dislipidemia I Pande Putu Deny Heriwijaya; I Made Jawi; Bagus Komang Satriyasa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: The conventional drugs for dyslipidemia theraphy needed to be concerned in the usage because of the side effect of the drugs. The Anthocyanin was one of the flavonoid compound that can be used as an alternative theraphy for dyslipidemia. The leaf of the purple sweet potato have been proved containing anthocyanin.Aim: The study aims to know the effectivity of the sweet potato leaf on lipid profile of male wistar rats induced by dyslipidemia feed extract.Method: The study design was pre and post-test control group design. Thirty white male rats were divided into five groups. All of the groups were given high-cholesterol diet for three months. Negative control groups of rats were given only high-cholesterol diet alone, positive control groups were given dyslipidemia drugs and the treatment groups were given sweet potato leaf water extract with the doses of each group were 3cc, 6cc and 9cc. Before and after treatment, lipid profile levels were measured.Results: There was a decrease in total cholesterol, triglyseride and LDL in treatmen group with 6cc and 9cc dose significantly (p<0,05) compared with the negative control group.Conclusion: The sweet potato leaf extract can improve the lipid profile of the dyslipidemia rats.Â Latar Belakang: Obat konvensional yang biasa dipakai untuk terapi dari dislipidemia masih harus diperhatikan dalam pemakaiannya karena masih adanya efek samping yang tidak diinginkan. Senyawa antosianin merupakan salah satu senyawa flavonoid yang dapat berpotensi sebagai terapi alternatif untuk dislipidemia. Pada daun ubi jalar ungu terbukti terdapat senyawa antosianin yang dapat digunakan sebagi terapi alternatif dislipidemia. Tujuan: untuk mengetahui efektivitas dari ekstrak daun ubi jalar ungu (Ipomoea batatas) terhadap profil lipid tikus putih jantan galur wistar yang diinduksi pakan dislipidemia. Metode: Rancangan penelitian adalah pre and post-test control group design. Penelitian dilakukan pada 30 ekor tikus putih jantan yang dibagi menjadi lima kelompok. Kelima kelompok tikus diberi makanan tinggi kolesterol selama tiga bulan. Pada kelompok tikus kontrol negatif hanya diberi pakan kolesterol, kontrol positif diberikan juga obat dislipidemia dan tiga kelompok perlakuan diberikan ekstrak air daun ubi ungu dengan dosis masing-masing kelompok 3cc, 6cc dan 9cc. Sebelum dan setelah mendapat perlakuan dilakukan pengukuran profil lipid. Hasil: Terdapat penurunan pada kolesterol total, trigliserida dan LDL pada kelompok perlakuan dengan dosis 6cc dan 9cc secara signifikan (p<0,05) dibandingkan dengan kontrol negatif. Kesimpulan: Pemberian ekstrak air daun ubi jalar ungu dapat memperbaiki profil lipid tikus dislipidemia.

Gambaran prevalensi penderita sifilis laten, sekunder, dan primer pada pasien Infeksi Menular Seksual (IMS) di Poliklinik Kulit dan Kelamin RSUD Mangusada, Badung, Bali periode 2017 â€“ 2018 Komang Indah Permata Dewi; Anak Agung Ari Agung Kayika Silayukti
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Venereal disease (syphilis) has long been known in Indonesia. However, the clinical manifestations of syphilis differ according to the stage in which they affect the treatment plan. Therefore, this study aims to determine the prevalence of latent, secondary and primary syphilis in sexually transmitted infections (STI) patients in the Skin and Venereal Polyclinic of Mangusada Regional Hospital, Badung.Methods: A cross-sectional observational study was conducted on secondary data from the medical records of Syphilis patients at the Mangusada Badung Hospital & Gynecology Clinic in January 2017-December 2018 using a total sampling technique. Syphilis prevalence in patients mainly from gender and clinical manifestations of syphilis are noted in this study. The data obtained were analyzed descriptively with SPSS software version 20 for Windows.Results: Total visits of cases of sexually transmitted infections (STI) were recorded as many as 332 people where syphilis cases were obtained by 35 cases (10.54%) with the proportion of new cases in syphilis patients by 28 cases (80.0%). Advanced stage syphilis was acquired in 32 cases (91.42%) followed by secondary stage (S-II) in 3 cases (8.58%) and there were no cases of manifestation of primary stage syphilis (0.00%). Based on sex, syphilis sufferers are dominated by women with 22 people (62.85 %%) while male gender is 13 people (37.15%).Conclusion: Most of the new syphilis cases in Mangusada Regional Hospital, Badung were found at patient visits with STIs, had advanced stage manifestations, and were dominated by female sex.Â Latar Belakang: Penyakit kelamin (veneral disease) seperti sifilis sudah lama di kenal di Indonesia. Akan tetapi, manifestasi klinik penyakit sifilis berbeda sesuai dengan tahapannya dimana berdampak pada rencana pengobatan. Oleh karena itu penelitian ini bertujuan untuk mencari tahu gambaran prevalensi sifilis laten, sekunder, dan primer pada pasien Infeksi Menular Seksual (IMS) di Poliklinik Kulit dan Kelamin RSUD Mangusada, Badung.Metode: Penelitian observasional potong lintang dilakukan terhadap data sekunder dari rekam medis pasien Sifilis di Poliklinik Kulit & Kelamin RSD Mangusada Badung pada Januari 2017-Desember 2018 dengan menggunakan teknik total sampling. Prevalensi Sifilis pada pasien terutama dari jenis kelamin dan manifestasi klinis sifilis dicatat pada peneltian ini. Data yang diperoleh dianalisis secara deskriptif dengan piranti lunak SPSS versi 20 untuk Windows.Hasil: Total kunjungan kasus infeksi menular seksual (IMS) tercatat sebanyak 332 orang dimana kasus sifilis diperoleh sebesar 35 kasus (10,54%) dengan proporsi kasus baru pada penderita sifilis sebesar 28 kasus (80,0%). Sifilis stadium lanjut diperoleh sebanyak 32 kasus (91,42%) diikuti dengan stadium sekunder (S-II) sebanyak 3 kasus (8,58%) dan tidak terdapat kasus manifestasi sifilis stadium primer (0,00%). Berdasarkan jenis kelamin, penderita sifilis didominasi oleh perempuan dengan jumlah 22 orang (62,85%%) sedangkan jenis kelamin pria berjumlah 13 orang (37,15%).Kesimpulan: Sebagian besar kasus baru sifilis di RSUD Mangusada, Badung ditemukan pada kunjungan pasien dengan IMS, memiliki manifestasi stadium lanjut, dan didominasi oleh jenis kelamin perempuan.

Larutan pencuci hidung salin isotonis tidak terbukti mempercepat waktu transpor mukosilia pada pasien dengan rinosinusitis akut di RSUP Sanglah, Bali, Indonesia Ni Putu Oktaviani Rinika Pranitasari; Luh Made Ratnawati; I Nyoman Adiputra
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Mucociliary clearance is a significant element of the defence system of the entire respiratory tract. Impairment of the mucociliary clearance serves as a medium for sinonasal infections. Saline nasal irrigation is believed to alleviated rhinosinusitis symptoms by clearing excess mucus, reducing congestion and remove infectious materials from the inspired air. This study aimed to determine the efficacy of mucociliary transport time of isotonic saline nasal solutions in patients with acute rhinosinusitis.Methods: An experimental study using pre- and post-test with control group design was conducted in this study. Mucociliary transport time was measured by the saccharine test on 20 acute rhinosinusitis patients before and after 7 daysâ€™ treatment with intranasal isotonic saline solutions and standard therapy (ciprofloxacin, pseudoephedrine/ triprolidine, ambroxol) for the case group and standard treatment for the control group. Data were analysed using SPSS version 20 for Windows.Result: The average mucociliary transport time before therapy was 35.5Â±10.7 minutes and 29.2Â±7.7 minutes for the case group and control group, respectively. The average mucociliary transport time after therapy was 22.9Â±8.7 minutes and 18.0 Â± 5.6 minutes for case group and control group, respectively. The mean difference mucociliary transport time before and after therapy was 11.0Â±7.5 minutes and 9.4Â±5.3 minutes for the case and control group, respectively (p=0.499).Conclusions: The addition of intranasal isotonic saline solutions in acute rhinosinusitis patients has the same effect of mucociliary transport time with oral medication with the antibiotic, decongestant, and mucolytic without intranasal isotonic saline solutions.Â Latar Belakang: Transpor mukosilia merupakan salah satu mekanisme pertahanan saluran pernapasan. Adanya gangguan pada sistem tersebut menjadi predisposisi terjadinya infeksi sinonasal. Larutan pencuci hidung dengan salin isotonis dipercaya dapat mengurangi gejala akibat rinosinusitis dengan cara membersihkan sekret, mengurangi odema dan mengeluarkan bahan-bahan berbahaya yang masuk bersama udara pernapasan. Tujuan penelitian ini adalah untuk menilai efektivitas waktu transpor mukosilia larutan pencuci hidung salin isotonis pada pasien rinosinusitis akut.Metode: Uji eksperimental dengan desai pre-post test dengan kontrol dilakukan pada penelitian ini. Waktu transpor mukosilia diukur menggunakan uji sakarin terhadap 20 pasien rinosinusitis akut sebelum dan 7 hari sesudah pemberian larutan pencuci hidung salin isotonis dan terapi standar (ciprofloxacine, pseudoephedrine/triprolidine, ambroxol) pada Kelompok Perlakuan dan terapi standar pada Kelompok Kontrol. Data dianalisis menggunakan SPSS versi 20 untuk Windows.Hasil: Rerata waktu transpor mukosilia sebelum perlakuan pada Kelompok Perlakuan adalah 35,5 Â± 10,7 menit dan 29,2 Â± 7,7 menit pada Kelompok Kontrol. Rerata waktu transpor mukosilia sesudah terapi adalah 22,9 Â± 8,7 menit dan 18,0Â±5,6 menit berturut-turut pada Kelompok Perlakuan dan Kelompok Kontrol. Median selisih waktu transpor mukosilia sebelum dan sesudah terapi adalah 11,0Â±7,5 menit pada Kelompok Perlakuan dan 9,4 Â± 5,3 menit pada Kelompok Kontrol (p=0,499).Kesimpulan: Penambahan larutan cuci hidung salin isotonis pada rinosinusitis akut memiliki efek waktu transpor mukosilia yang sama dengan pemberian antibiotika, dekongestan dan mukolitik tanpa larutan cuci hidung salin isotonis.

Diagnosis dan tatalaksana Sindroma Stevens-Johnson (SJS) pada anak: tinjauan pustaka Komang Ayu Witarini
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: Stevens-Johnson Syndrome (SJS) is an emergency situation with a fairly high mortality rate characterized by a triad of lesions on the skin, mucosa orifice, and eyes. In general, SJS is caused by a reaction to a drug. This literature review is trying to explain more in the effort to diagnose and manage SJS specifically in children.Methods: This literature review involved 14 relevant literature from 1990-2011 about SJS. Different data sources or manual literature search methods used to find articles related to the topic of literature.Results: The diagnosis of SJS is mainly based on clinical symptoms. The clinical picture of SJS is known to be very similar to Toxic Epidermolysis Necrotikans (TEN). Various efforts to stop all drugs given previously is the main treatment, supported by supportive treatment of accompanying symptoms. The mortality rate depends on the presence of severe complications and delay of treatment.Conclusion: Early diagnosis and prompt treatment are the key to the management of SJS in children.

Gambaran pola makan, kecukupan gizi, dan status gizi mahasiswa Fakultas Kedokteran Universitas Mataram, Nusa Tenggara Barat Rifana Cholidah; Ida Ayu Eka Widiastuti; Lina Nurbaiti; Seto Priyambodo
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Nutritional problem is a problem that still faced by developed countries and developing countries. An unbalanced diet is one of the causes of nutritional problems. Several studies have shown that students have an unhealthy diet and eating habits. Several factors influences such as high academic activity, limited food choices around the campus, and choosing food at affordable prices. This study aims to determine the eating pattern, nutrition adequacy, and nutritional status of the students in the Medical Faculty of Universitas Mataram, Mataram, West Nusa Tenggara, Indonesia.Methods: This descriptive-analytical study involving students of the Medical Faculty of Universitas Mataram who met the inclusion and exclusion criteria as subjects. Subjects were obtained using a consecutive sampling method. Measurement of dietary and nutritional adequacy using a 24-hours food recall questionnaire and NutriSurvey software, and calculation of nutritional status based on body mass index (BMI).Results: A total of 88 students were included in this study. Students with proper and improper diet pattern were 38 (43.18%) and 50 (56.82%). Students with sufficient nutrition were 42 (47.73%), and 46 (52.27%) were lack of adequate nutrition. Based on the nutritional status, 18 (20.45%) were underweight, 58 (65.91%) were normal, 8 (9.09 %) were overweight, and 4 (4.54%) were obesity.Conclusion: Most students have improper eating patterns, lack of adequate nutrition, and normal nutritional status.Â Latar belakang: Masalah gizi berupa kekurangan dan kelebihan gizi masih menjadi masalah baik di negara berkembang maupun negara maju. Masalah gizi ini dapat disebabkan adanya pola makan yang tidak seimbang. Beberapa penelitian menunjukkan bahwa mahasiswa memiliki pola makan dan kebiasaan makan yang tidak sehat, karena pengaruh beberapa faktor seperti kesibukan akademik, pilihan makanan yang terbatas di sekitar kampus, dan memilih makanan dengan harga yang terjangkau. Penelitian ini bertujuan untuk mengetahui gambaran pola makan, kecukupan gizi, dan status gizi mahasiswa Fakultas Kedokteran Universitas Mataram, Nusa Tenggara BaratMetode: Penelitian ini adalah penelitian analitik deskriptif dengan desain potong-lintang. Subjek penelitian adalah mahasiswa Fakultas Kedokteran Universitas Mataram yang memenuhi kriteria inklusi dan eksklusi. Subjek penelitian diperoleh dengan menggunakan metode consecutive sampling. Pada subjek dilakukan analisis pola makan dan kecukupan gizi menggunakan kuisioner 24-hourÂ food recallÂ dan software NutriSurvey, serta perhitungan status giziÂ berdasarkan indeks massa tubuh (IMT).Hasil: Sebanyak 88 mahasiswa diikutsertakan dalam penelitian ini. Terdapat 38 mahasiswa (43,18%) dengan pola makan yang benar dan 50 mahasiswa (56,82%) dengan pola makan yang salah. Terdapat 42 mahasiswa (47,73%) cukup gizi dan 46 mahasiwa (52.27%) berada pada angka kecukupan gizi kurang. Untuk status gizi, 18 mahasiswa (20,45%) dengan status gizi kurang, 58 mahasiswa (65,91%) dengan status gizi normal, 8 mahasiswa (9,09%) dengan status gizi berat badan lebih, dan 4 mahasiswa (4,54%) dengan status gizi obesitas.Simpulan: Pola makan mahasiswa sebagian besar masih kurang tepat, angka kecukupan gizi sebagian besar kurang. Sebagian besar mahasiswa mempunyai status gizi normal.

Pengaruh ekspresi Vascular Endothelial Growth Factors (VEGF) post-neoadjuvant kemoterapi terhadap respon kemoterapi (huvos), local recurrence, metastasis, dan survival pada pasien osteosarkoma Kadek Ayu Candra Dewi
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: Overexpression of VEGF before therapy has been associated with decreased survival and poor prognosis of osteosarcoma patients, but VEGF expression in osteosarcoma patients following receiving neoadjuvant chemotherapy has not been much elucidated. The purpose of this study was to determine the effect of VEGF expression after neoadjuvant chemotherapy on chemotherapy responses (HUVOS), local recurrence, metastases and survival of osteosarcoma patients.Methods: A cross-sectional study was conducted in Jakarta during the 2009-2010 period to 19 osteosarcoma patients at Cipto Mangunkusumo Hospital, Jakarta. Data on patientâ€™s characteristics, VEGF expression after chemotherapy, local recurrence, metastasis, chemotherapy response and survival in osteosarcoma patients were recorded and analysed using statistical analysis. All data were analysed using SPSS software version 16 for Windows.Results: Most respondents were male (63.2%), age> 14 years (84.2%), stage IIB (94.7%), poor HUVOS (73.7%), size <10 cm (63, 2%), positive VEGF expression (57.9%), negative metastasis (73.7%), and death (73.7%). There was no significant relationship between VEGF expression and all parameters assessed (P> 0.05).Conclusion: VEGF expression by living osteosarcoma cells after neoadjuvant chemotherapy is not significantly related to histological response (HUVOS), local recurrence and metastasis, but has a significant relationship with good survival.

Seorang penderita kanker paru dengan manifestasi efusi perikardium: Laporan kasus Ida Ayu Nanda Dwijayanthi; Ida Bagus Sutha
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Based on WHO data, lung malignancy is the most common cause of death in patients with cancer. On the other hand, 10-20% of metastasis involves pericardium.Â Pericardial effusion is associated with variety of underlying heart diseases, malignancies, infections and complications of cardiovascular procedures. However, in some cases, MPE may manifest to cardiac tamponade which cause collapse of cardiovascular system and will eventually lead to death.Case description: We reported 51 years old male patient with chief complain of shortness of breath especially when lying down. Patient has history of the same complaints and had done pericardiocentesis in the past. Patient were now hospitalized with severe pericardium effusion post-cardiocentesis and stage IV pulmonary malignancy. Biopsy showed that the patient had squamous cell carcinoma. Two weeks after the lung biopsy, patientâ€™s condition worsened and patient eventually passed away. Patient was planned to have paclitaxel-carboplatin chemotherapy after biopsy. Pericardium effusion is associated with cardiac metastases, which most often originate from lung malignancy. There are four mechanism of pericardial metastasis, such as direct extension, through blood vessel, lymphatic vessel and through intracavity diffusion either through cava vein or pulmonary vein. Cardiac tamponade is a life-threatening complication caused by accumulation of excessive fluid which cause extracardial compression and haemodynamic instability. Therefore, pericardiocentesis is needed as an emergency and life-saving procedure.Conclusion: Chemotherapy may increase the survival rate of patients with MPE.Â Latar belakang: Data WHO menunjukan bahwa kanker paru merupakan penyebab kematian utama akibat keganasan dimana angka insiden keganasan yang melibatkan metastasis pada pericardium sekitar 10-20%. Efusi perikardium sering dihubungkan dengan berbagai macam penyakit seperti penyakit jantung, keganasan, infeksi dan sebagai komplikasi prosedur tindakan kardiovaskuler. Pada beberapa kasus metastasis jantung dapat bermanifestasi menjadi tamponade jantung sehingga menyebabkan kolaps sistem kardiovaskuler yang dengan cepat dapat menyebabkan kematian.Deskripsi kasus: Kami melaporkan seorang pasien laki-laki berusia 51 tahun dengan keluhan sesak nafas terutama berbaring. Pasien sudah mengalami keluhan yang sama berulangkali dan telah dilakukan perikardiosintesis. Saat ini pasien dirawat dengan efusi perikardium berat post-kardiosentesis dengan keganasan paru stadium IV dengan hasil biopsi karsinoma sel skuamosa. Pasien mengalami perburukan dan meninggal dua minggu setelah biopsi paru. Seharusnya setelah dilakukan biopsi paru, pasien direncanakan untuk menjalani kemoterapi paclitaxel-carboplatin. Efusi pericardium sering dikaitkan dengan proses metastase jantung dimana penyebabnya paling banyak berasal dari keganasan pada paru. Penyebaran tumor ke jantung dapat melalui empat jalur yaitu secara langsung (direct extension), melalui pembuluh darah, melalui sistem limfe dan melalui difusi intrakavitas baik melalui vena kava maupun vena pulmonaris. Komplikasi yang sering terjadi adalah tamponade jantung yaitu suatu kondisi mengancam jiwa yang disebabkan oleh akumulasi cairan yang terlampau banyak sehingga menyebabkan kompresi ekstrakardial dan gangguan hemodinamik yang membahayakan sehingga diperlukan perikardiosentesis sebagai tindakan emergensi.Kesimpulan: Pemberian kemoterapi dapat memberikan peningkatan angka kesintasan pasien.

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Bali

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name -

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Phone -

Journal Mail Official -

Editorial Address -

Location Kota denpasar, Bali INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA